Systematic Review of Polypharmacy Definitions

Articles that met the inclusion criteria and provided a definition of polypharmacy were included. One author (NM) conducted the initial database search and primary screening of article titles and abstracts and articles were categorised as: relevant, irrelevant or unsure. Three reviewers (NM, SS, GC) discussed the appropriateness of inclusion of each article classed as relevant or unsure. Once all relevant articles were identified, one author (NM) reviewed full texts of all identified articles and extracted the data. A pre-defined data extraction template was developed by all authors and then applied to ensure consistent data extraction from each of the identified studies. Data items extracted included the definitions of polypharmacy and associated terms such as minor, moderate and excessive polypharmacy and whether studies distinguished between appropriate and inappropriate polypharmacy and if so, how this distinction was made or defined. The definitions of polypharmacy and associated terms were categorised as: i. numerical only (using the number of medications to define polypharmacy), ii. numerical for a given duration of therapy or healthcare setting for e.g. during hospital stay or iii. Descriptive (using a brief description to define polypharmacy). Once the primary data extraction was complete all authors reviewed the content analysis for each of the extracted studies, with data further categorised and summarised in tables.